Suicides worry war veterans, who turn to each other for kinship

Before a
good friend of David Smith, Keith Branch and Daniel Burmeister committed
suicide, he arranged all his medications on a tabletop, took a photo with his
cellphone and sent the image to his friends. The picture spoke volumes to the
fellow combat veterans.

For one
thing, the trio look with a skeptical eye at the many pills prescribed to each
of them. All three are former U.S. Marines who survived the battlefields in
Afghanistan. Now that they are back home in Texas, they are trying to figure
out how to survive the rest of their lives.

Their
friend’s final message underscored that it will take more than enduring long
waits for care at VA clinics and filling prescriptions.

Their
friend’s death also came not long after the U.S. military announced a
record-setting 349 soldiers had committed suicide in 2012. More soldiers died
at their own hands than in combat.

And then
came another report — a recent Department of Veterans Affairs study that found
veteran suicides were increasing, too. U.S. veterans are taking their own lives
at a rate of an estimated 22 per day, the study found.

Branch,
26, now a student at the University of Texas at Arlington, counts at least nine
soldiers from his unit who have committed suicide since they all returned to
the U.S.

Smith,
23, a student at the University of North Texas, said he knew something was
wrong with his friend in the hours before he killed himself.

“The
person I was hanging out with the day before was not him,” Smith said.

Thoughts of suicide

When he
got to UNT, Smith knew to look for others like him — military veterans who
hadn’t just served but who had also seen combat.

Soldiers
train for cohesion in their company, but not all veterans are kindred spirits.
Veterans who fired at the enemy, who were fired upon, who saw their buddies
die, who had their own bodies mangled — those veterans share a different
kinship, he said.

Smith
soon found that friendship with combat veterans his age. He also found support
from his mentor, UNT professor Guenter Gross, who is a combat veteran of the
Vietnam War. Gross is quick to say that, even though he was shot at while
piloting his missions, he didn’t see the kind of combat that Smith and the
others did.

As Smith
settled into his studies, which include helping in Gross’ research in the
Center for Network Neuroscience, he began questioning the effects of some of
his medications. Together, Gross and Smith looked at drug reference books so he
could better understand the medicines.

At
various times, in addition to pain medication, Smith was prescribed a sleep
aid, an antidepressant, an anti-anxiety medication and, for his nightmares, a
common blood pressure medicine. When he was taking both the sleep medicine and
the antidepressant, both serotonin re-uptake inhibitors, he learned that taking
more than one SSRI can cause thoughts of suicide.

Branch
said he believes that some combination of his prescriptions had triggered ideas
of suicide. He stopped taking some of them, even though he knew that meant he
could get in trouble with his VA doctor for being noncompliant.

Burmeister,
24, and home for two years now, still waits for the VA to review his claim, but
he knew that he, too, needed help.

“I went
to mental health services by myself,” Burmeister said.

Smith
also stopped taking some of his prescriptions and asked the VA for counseling
instead. He believed that, like his friend who had committed suicide, his
medications had put the idea of suicide in his head.

It was
several tense months this spring as Smith waited for the counselor to find time
to see him, he said.

“Suicide
would be the very last thing I would do, but it puts those thoughts in your
head,” Smith said.

That was
the only time he thought about how bad his life was, he said.

Battle scars

In early
June 2010, a water truck had arrived in Musa Qa’lah, where Smith and the rest
of his unit were stationed outside Sangin Valley, in the Helmand province of
Afghanistan. Something inside told him he was making a mistake by running up to
the truck, Smith said, but he didn’t stop.

The
truck’s back wheels hit an improvised explosive device. The resulting explosion
injured the driver and nine Marines. Smith’s right leg and gut were badly
injured in the blast.

He was
sent back to San Diego to recover. His wounds required four major surgeries. He
sees an ophthalmologist every three months to monitor his eyesight. Once, the
doctors tried giving him Botox to help combat the headaches, he said.

It didn’t
help.

While
Smith was recovering, he got addicted to painkillers, he said. He hung around
other combat veterans who were addicts, too. Some of his new buddies were
homeless. His addiction didn’t bother him until one day someone offered him
heroin. He entertained the idea. Then, he knew it was time to get clean.

It was
three weeks of “hellacious withdrawal,” but he made it, the Frisco High School
graduate said.

He got
help through a well-known program in California, the Veterans Village of San
Diego.

When it
was time to go back home to Texas, Jack Lyon, one of five Vietnam veterans who
helped start the San Diego program in 1981, told Smith to reach out and make
friends in Texas who would understand.

Civilian again

Many
veterans often struggle to reassimilate once they are back home, says Paul
Bastaich of Denton County Veterans Services. Some veterans, like Smith and
Branch, take full advantage of the GI Bill, which offers 36 to 48 months of
support to finish a college degree.

Money for
tuition and housing, as well as a stipend, go a long way, but many veterans
soon learn attending college is stressful, too, Bastaich said.

The VA
has good programs for combat stress, post-traumatic stress disorder and other
mental health problems, he said.

“I’ve
seen a lot of success with people coming back and being a civilian again,” he
said.

But the
VA also is a “socialized” health care system, and accessing that care and
treatment can take a lot of time, Bastaich said.

“That
time away can be the biggest problem,” he said.

Sometimes
the degree of mental health care available to a combat veteran also depends on
the battalion commanders, Smith said.

“A lot
depends on how bad they think the deployment was,” Smith said.

Branch
said he thinks the speed of care matters, too, and he thinks the VA could do
more to focus on combat veterans.

“There
are so many claims, but they should make combat claims a priority,” Branch
said.

The VA’s
own study appears to bear that out. Findings showed that the first four weeks
following service were key, requiring intensive care and case management for
those veterans most at risk of suicide.

Buddy system

When a
buddy commits suicide, the questions many combat veterans are wrestling with
resurface, said Lyon, one of the Veterans Village founders.

“If
you’re a ‘grunt,’ a combatant, if you are doing the deal, the dance, you feel
death on your neck,” Lyon said. “You are thrust into the nexus of life and
death and you are never the same after that.”

Smith
remembers another day, when he had the enemy in the scope of his TOW missile.
His unit had taken heavy fire from that position in the mountains the night
before.

In the
morning, they spotted a small group of men they believed to be the shooters,
but they had gathered in a prayer circle. Smith waited for hours to make his
shot, waiting for the evidence that they, too, were combatants. Once he saw
that, he fired. His shot traveled 3,967 meters and killed eight men, he said.

When one
lives and another dies, and a soldier had a hand in it, Lyon said, the classic
question returns: “Why am I here?”

Combat
stress dates back to ancient Greece. Mental health disorders were rampant among
World War II veterans, some of whom never got help, Lyon said.

“And to
my generation, it was debilitating. It took us 10 years to find each other,”
Lyon said.

He is
hopeful that the current generation of soldiers will cut that time for help
with combat stress even further.

If a
combat veteran goes to the VA with panic attacks, the doctor might prescribe a
medicine to deal with the symptoms, but that won’t get to the underlying
problem, Lyon said.

Context
is important, he said.

“That’s
why the best treatment is warrior-to-warrior, one generation to the next,” Lyon
said. “It’s a spiritual issue.”

That can
be bewildering for others who knew the soldier before deployment and after.

Branch’s
marriage fell apart.

“The
anxiety and depression that resulted make it hard to have good relationships,”
Branch said.

Combat
veterans don’t have time to grieve on the battlefield, and that experience
becomes a casualty of its own, Lyon said.

“The rage
comes from being helpless, and watching a friend die,” Lyon said.

It takes
a long time to learn to trust again. Yet, when a veteran comes home, family and
friends expect the same person has returned, Lyon said.

“We have
welcome-home events, and parades, and parties, and that’s very nice,” Lyon
said.

But
that’s not what the wounded soul of a combat veteran needs, he said.

“He needs
to exhale and find someone with context, someone who can let him know it’s
going to be OK,” Lyon said.

The
program Lyon and his friends started 30 years ago is one that provides such
context and has been a model for other programs that link combat veterans
together for support, he said.

Friends
and family need to know that is OK that the combat veteran has changed — it’s a
gift even, Lyon said, that the veteran knows things about life and death that
most of the rest of us don’t really understand.

“They know
that space of silence and openness,” Lyon said.

PEGGY HEINKEL-WOLFE can be reached at
940-566-6881 and via Twitter at @phwolfeDRC.

June is
PTSD Awareness Month

Veterans
with combat stress, or who suspect they may suffer from post-traumatic stress
disorder, can get help. The National Center for PTSD has information to help
veterans and their families find local mental health services. More information
on trauma and PTSD can be found on the center’s website, www.ptsd.va.gov.

Veterans
in crisis should call 911, go to the nearest emergency room, or call either the
Suicide Prevention Lifeline at 1-800-273-8255 or the Veterans Crisis Line at
1-800-273-8255 for a confidential chat with a counselor.

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